Ulu Kukui o Kaulike: From State Legislation That Integrates Native Hawaiian Values Toward Investment in Medicaid

Ulu Kukui o Kaulike: From State Legislation That Integrates Native Hawaiian Values Toward Investment in Medicaid

This Snapshot of Innovation is made up of nine stations outlining a 10-year cross-sectoral research and community planning effort that successfully shaped legislation across all agencies to codify a state commitment to addressing health disparities among Native Hawaiians by 2030.

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Snapshots of Innovation are presented each year at the Robert Wood Johnson Foundation’s Sharing Knowledge to Build a Culture of Health conference and spotlight ground-breaking research or community efforts to improve health, equity and well-being. 

Voted on by attendees in March 2020, this Snapshot outlines an initiative where the government has had a role in positively impacting racial justice and health equity for Native Hawaiians. Ulu Kukui o Kaulike is a culturally grounded policy walk that grows from the traditional metaphor of a kukui grove for justice and equity by exploring Native Hawaiian health and well-being successes experienced over the last decade. The kukui is the official tree of Hawai’i and of deep cultural and spiritual importance to Native Hawaiians (Indigenous people of Hawai’i).

Each station of this Snapshot follows the seven stages of the kukui’s growth as an interactive metaphor to share knowledge emphasizing a phased process applying the Native Hawaiian Culture of Health:

Cultural Foundation: Improving health from an authentic worldview of Mauli Ola and Native Hawaiian well-being;

Community Cohesion: Population health goals to eliminate health disparities and racial inequalities among Native Hawaiians;

Equity Research and Policy Analyses: Cross-sectoral research based on community needs shapes appropriate health policy solutions;

Systems Advocacy: Harness community cohesion to enact legislation that integrates Native Hawaiian values;

Legislative Compliance and Enforcement: Substantive policy change requires ongoing attention for complex health goals to be achieved;

Investment for SDOH and Disparate Populations: Meaningful multi-year investment by the federal, state, and local government is needed to uplift Native Hawaiians living in poverty;

Population Strengthening: At the core of social justice for Native Hawaiians is racial equity and healing.


Kealoha Fox, Ph.D., M.A.

Native Hawaiian Cultural Liaison - AlohaCare

Kealoha Fox, Ph.D., M.A., is a Native Hawaiian biomedical scientist and traditional practitioner. Read Bio